Assessing implementation fidelity of an on-site pharmacist intervention within Australian residential aged care facilities: A mixed methods study.

Batten, M; Koerner, J; Kosari, S; Naunton, M; Lewis, J; Strickland, K

Assessing implementation fidelity of an on-site pharmacist intervention within Australian residential aged care facilities: A mixed methods study.

Batten, M Koerner, J Kosari, S Naunton, M Lewis, J

Strickland, K

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Publisher:: BMC
Publication Type:: Journal Article
Citation:: BMC Health Serv Res, 2023, 23, (1), pp. 1166
Issue Date:: 2023-10-27

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Field	Value	Language
dc.contributor.author	Batten, M
dc.contributor.author	Koerner, J
dc.contributor.author	Kosari, S
dc.contributor.author	Naunton, M
dc.contributor.author	Lewis, J https://orcid.org/0000-0001-8668-712X
dc.contributor.author	Strickland, K
dc.date.accessioned	2024-01-12T05:27:59Z
dc.date.available	2023-10-18
dc.date.available	2024-01-12T05:27:59Z
dc.date.issued	2023-10-27
dc.identifier.citation	BMC Health Serv Res, 2023, 23, (1), pp. 1166
dc.identifier.issn	1472-6963
dc.identifier.issn	1472-6963
dc.identifier.uri	http://hdl.handle.net/10453/174389
dc.description.abstract	BACKGROUND: An on-site pharmacist (OSP) intervention was implemented which sought to improve medication management within residential aged care facilities (RACFs) in the Australian Capital Territory, Australia. The objectives of this mixed methods study were to evaluate the implementation fidelity of the OSP intervention and to determine the moderating factors which influenced delivery of this intervention. METHODS: This convergent parallel mixed methods study was underpinned by Hasson's conceptual framework for implementation fidelity. Implementation fidelity for seven intervention RACFs was quantitatively assessed using three quantitative data sets: (1) range of OSP intervention activities delivered; (2) random sample of 10% of medication reviews assessed for quality; (3) proportion of residents who received at least one medication review. Semi-structured interviews (n = 14) with managers and OSPs across the intervention RACFs were conducted to identify moderating factors which may have influenced OSP intervention delivery. RESULTS: The OSP intervention was generally delivered as intended with overall medium levels of implementation fidelity. This delivery was supported by a range of facilitation strategies with most participants perceiving that the intervention was delivered to a high standard. RACF managers and OSPs were mostly well engaged and responsive. A number of potential barriers (including the part-time OSP role, COVID-19 pandemic, RACFs spread out over a large area with significant distance between resident dwellings) and facilitators (including the pharmacist support meetings, OSPs who took time to establish relationships, RACF managers who actively supported OSPs and worked with them) for OSP intervention delivery were identified which have potential implications for the roll out of OSPs within Australian RACFs. CONCLUSION: In this study, the implementation fidelity of OSP intervention delivery was assessed with overall medium levels of fidelity found across the intervention RACFs. This suggested that the OSP intervention can generally be delivered as intended in real world RACFs. OSP intervention delivery was influenced by a range of moderating factors, some of which posed barriers and others which facilitated the OSP intervention being delivered as intended.
dc.format	Electronic
dc.language	eng
dc.publisher	BMC
dc.relation.ispartof	BMC Health Serv Res
dc.relation.isbasedon	10.1186/s12913-023-10172-9
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	0807 Library and Information Studies, 1110 Nursing, 1117 Public Health and Health Services
dc.subject.classification	Health Policy & Services
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4205 Nursing
dc.subject.classification	4206 Public health
dc.subject.mesh	Aged
dc.subject.mesh	Humans
dc.subject.mesh	Australia
dc.subject.mesh	Pharmacists
dc.subject.mesh	Pandemics
dc.subject.mesh	Homes for the Aged
dc.subject.mesh	Research Design
dc.subject.mesh	Humans
dc.subject.mesh	Research Design
dc.subject.mesh	Aged
dc.subject.mesh	Pharmacists
dc.subject.mesh	Homes for the Aged
dc.subject.mesh	Australia
dc.subject.mesh	Pandemics
dc.subject.mesh	Aged
dc.subject.mesh	Humans
dc.subject.mesh	Australia
dc.subject.mesh	Pharmacists
dc.subject.mesh	Pandemics
dc.subject.mesh	Homes for the Aged
dc.subject.mesh	Research Design
dc.title	Assessing implementation fidelity of an on-site pharmacist intervention within Australian residential aged care facilities: A mixed methods study.
dc.type	Journal Article
utslib.citation.volume	23
utslib.location.activity	England
utslib.for	0807 Library and Information Studies
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access	*
dc.date.updated	2024-01-12T05:27:58Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	23
utslib.citation.issue	1

Abstract:

BACKGROUND: An on-site pharmacist (OSP) intervention was implemented which sought to improve medication management within residential aged care facilities (RACFs) in the Australian Capital Territory, Australia. The objectives of this mixed methods study were to evaluate the implementation fidelity of the OSP intervention and to determine the moderating factors which influenced delivery of this intervention. METHODS: This convergent parallel mixed methods study was underpinned by Hasson's conceptual framework for implementation fidelity. Implementation fidelity for seven intervention RACFs was quantitatively assessed using three quantitative data sets: (1) range of OSP intervention activities delivered; (2) random sample of 10% of medication reviews assessed for quality; (3) proportion of residents who received at least one medication review. Semi-structured interviews (n = 14) with managers and OSPs across the intervention RACFs were conducted to identify moderating factors which may have influenced OSP intervention delivery. RESULTS: The OSP intervention was generally delivered as intended with overall medium levels of implementation fidelity. This delivery was supported by a range of facilitation strategies with most participants perceiving that the intervention was delivered to a high standard. RACF managers and OSPs were mostly well engaged and responsive. A number of potential barriers (including the part-time OSP role, COVID-19 pandemic, RACFs spread out over a large area with significant distance between resident dwellings) and facilitators (including the pharmacist support meetings, OSPs who took time to establish relationships, RACF managers who actively supported OSPs and worked with them) for OSP intervention delivery were identified which have potential implications for the roll out of OSPs within Australian RACFs. CONCLUSION: In this study, the implementation fidelity of OSP intervention delivery was assessed with overall medium levels of fidelity found across the intervention RACFs. This suggested that the OSP intervention can generally be delivered as intended in real world RACFs. OSP intervention delivery was influenced by a range of moderating factors, some of which posed barriers and others which facilitated the OSP intervention being delivered as intended.

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http://hdl.handle.net/10453/174389